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Feeding through an Ostomy Bag Using a
Universal Catheter Access Port

Some time ago we published a tip on how to adapt an ostomy bag to allow a
feeding tube to pass through it without leakage (LifelineLetter, July/August 2002). We recently shared that tip with Oley member Emily
Convery, who adapted the suggested procedure a little and sent us wonderful
photos, along with some updated information. The article below reflects much of
the original, with Emily’s photos and updates.

Please
discuss this idea with your physician before you try it.

Most
physicians see important advantages to a patient using his or her
gastrointestinal tract, even if accessing it is somewhat complicated. For
example, tube feeding is sometimes done through a small bowel ostomy that is the
site of some secretions and requires an ostomy bag. This might happen if the
patient has a loop small bowel ostomy and feeding into the more distal segment
of the bowel is desirable, or if the patient has a Roux-en-Y feeding jejunostomy.

The ostomy
bag is essential so the secretions from the proximal bowel do not irritate the
skin, so the challenge is to insert the feeding tube through the ostomy bag and
into the distal segment for feeding. This can be achieved by gluing a universal
catheter access port (a soft plastic cone) into the ostomy bag. The directions
below take you through this process with some helpful hints by Emily.

Emily uses
a two-piece ostomy system: “The barrier (also know as a wafer or base plate)
stays on my skin around the stoma and the bags fit onto it. This is crucial for
protecting the skin around my stoma because the base only gets changed every
three to five days.” The adapted bags, she says, “have worked wonderfully! I am
now able to go to school and work and function just fine with the tube hooked up
and hardly anyone notices.” When she doesn’t need to use a feeding tube, Emily
applies a regular bag or a stoma cap to the barrier.

block
of wood, approximately 2” x 4” x 4”, with a hole the diameter of the port’s
outer ring drilled through it. (Emily notes, “I was able to go to Home Depot
and get a couple of blocks of wood for about $1 each; the hole was easily
made using a 1” drill bit I got for about $5 and which fit into a standard
drill. It was very easy.” See photos 1–3.)

ostomy
bag (Emily notes: “I use urostomy pouches with the tube. I use three
different sizes, depending on how much drainage I am having and what
clothing I am wearing. The small one is a micro-pouch, the medium one is a
pediatric urostomy bag, and the biggest one is an adult urostomy appliance.
[See photo 4.] The barrier I use fits all three sizes, as well as the stoma
cap or small bag I wear when I do not have the tube in.”)

Photo 4: Three finished pouches

Gluing the port into the ostomy bag:

1. Put the
outer ring on the port (soft white cone) and place them tip down into the hole
in the wooden block (photo 5).

2. Put glue around the perimeter of the outer ring (photo 6).

3. Place the ostomy bag face (hole-side) up on top of the port on the block,
centering the bag’s hole over the port (photo 7). Emily notes, “This makes the
pointed part of the tube adapter face outward; I had tried having the adapter
point inward, but my stoma was getting a little sore and actually bleeding a
little bit if I had it going this way.”

Photos 5-7: Gluing the port into the ostomy bag

4. Place
the inside ring on the hard blue cone (photo 8), and carefully apply a small
amount of glue to the exposed surface of the inside ring (photo 9).

5. Poke the
blue cone (tip side down) through the opening on the ostomy bag, through the
back of the ostomy bag, and into the white cone (photo 10). This will create a
hole in the ostomy bag, and leave the port sandwiched between the inner and
outer rings.

Photos 8-10: Gluing the insert into the bag

6. Hold in
place until the glue sets (about 1 to 2 minutes). Remove the blue cone.

7. Snip the tip of the port carefully, making a hole just large enough to fit
the feeding tube through. Emily notes, “The tip of the blue cone will make a
hole in the bag large enough for the tube to fit through. I prefer not to
completely cut the remaining bag out from the center of the hole because it
prevents secretions/drainage from accumulating in the cone.”

8. After
experimenting with the adapted bags, Emily added a step to glue the tube in
place in the port. But note: you need to measure the length of the tube before
you glue it. This way when you put the bag and tube in place, the tube will be
situated appropriately in the distal bowel, as recommended by your physician.
Emily says, “I put a thin layer of glue inside the cone after the tube has been
put through to prevent the occasional leaking I had there, because the cone does
not make a tight enough seal.”

9. To
prepare for a feeding, insert the feeding tube that comes out of the port into
the distal bowel and attach the ostomy bag to your body.

Photos 11-13: The finishing touches

Emily
prepares several bags of various sizes at once, so they are ready when she needs
them (photo 4 with tubes, and photos 11–13, without tubes). Emily notes, “It is
important to wait twelve to twenty-four hours before using the bags, to allow
the glue time to dry—even if it is labeled ‘quick dry.’ I lay them all out on a
trash bag or cheap plastic tablecloth while they dry in case any of the glue
runs. (I had to cut one out of my carpet once.) I also recommend wearing gloves
when dealing with the glue because it’s sometimes painful if you get it on your
hands. Also, the bags can be used multiple times. I get special cleaners for
ostomy appliances from my medical supply company to wash them when they are not
in use.”

This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.

Updated in 2015 with a generous grant from Shire, Inc.

This website was updated in 2015 with a generous grant from Shire, Inc. This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.